COMPARABLE OUTCOMES IN ROBOTIC AND LAPAROSCOPIC BARIATRIC SURGERY

Abstract

Background: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a well-established surgical treatment for morbid obesity. Robotic-assisted RYGB has recently emerged as an alternative approach with potential advantages in reducing perioperative complications. This study aimed to compare outcomes of robotic versus laparoscopic RYGB in a teaching institution over a defined period. Methods & Material: This prospective comparative study included 231 consecutive patients who underwent minimally invasive RYGB between January 2024 and June 2024. Patients were divided into two groups: robotic RYGB (n=121, 52.4%) and laparoscopic RYGB (n=110, 47.6%). Data were collected prospectively and analyzed for operative time, conversion rate, perioperative complications (Clavien-Dindo classification), reoperations, hospital stay, and weight loss outcomes. Results: Operative time was significantly longer in the robotic group. However, robotic RYGB demonstrated a lower conversion rate and reduced overall postoperative complications compared to laparoscopic surgery. Anastomotic leak rates and early reoperations were also lower in the robotic group. Hospital stay was shorter in robotic cases. Mortality was comparable between both groups with one case in each cohort. While learning curve effects improved operative efficiency over time, no significant impact on overall morbidity or mortality was observed. Laparoscopic patients demonstrated slightly greater long-term BMI reduction compared to robotic patients. Conclusions: Robotic RYGB is a safe and feasible alternative to laparoscopic RYGB, offering improved short-term perioperative outcomes, including lower conversion rates, fewer complications, and shorter hospital stay. However, laparoscopic surgery showed marginally better long- term weight loss outcomes. Further studies are required to define the optimal role of robotic bariatric surgery.